Green employees (nurses) in ER

  1. Just a question in general--how do people feel about new, right-out-of-school RNs running right into ER? Are we ready--for those of you have some experience? Is it someplace you feel comfortable training a greenie? Or, where would you recommend that the new RN start training and gain some experience before jumping in the fire?
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  2. 26 Comments

  3. by   RNforLongTime
    I believe that a year of med-surg experience is good preparation for a specialty floor such as ER, ICU, etc. You need to learn how to properly assess a patient that isn't critical. But now a days with the shortage if you want to work in ER and they'll hire you as a new grad then I say go for it! Good luck!
  4. by   l.rae
    I agree. There are some exceptions, the paramedics that have worked er and gone back to school seem to adapt very well. Not to say they couldn't benefit from the med/surg exp. though. My hospital has an ER residency program. This is a great way for new nurses and nurses changing specialties to be introduced into the er culture. and it is a culture all it's own. Good luck
  5. by   CATHYW
    If you are a sharpe person who did well in clinicals in school, 6 mos. on Medical, or Med/Surg should give you the background that you need. Prioritizing is essential, and evaluating the patient as not only a person but a set of integrated systems is essential. Remember the old saw-for each action, there is an equal and opposite reaction. If you don't understand the basics of the human condition, and the responses to interventions, you won't be able to accurate assess and intervene in a HURRY in the ER. In our ER, when we had a good student on ER orientation, we used to let the instructor know that they had potential for ER work. Check with your Clinical Instructor and see what the comments were about your ER rotation.
  6. by   RoaminHankRN
    I would be wrong to say no to a new grad in the ER. That is how I started. Each person should be evaluated for the job. I think personality is important. Not everyone has what it takes to be an ER nurse. Cathy WilsonRN brought up a valid point.. to intervene in a hurry. That also goes with your assesment. What are you taught in nursing school. A thorough AX. In the ER it has to be focused on the complaint and quick. Can the person handle stress and a "non" routine shift. You never know what is going to come and how many through that door. On the floors you know and have your limits.
    It's a different world down there. Would I recommend it? Sure. But keep your mind fresh (have a life!) and options open down the line. I can't speak for certain but I think ER ranks up there with the type of nursing one will burnout from. (OR is the other I think) After 10 years, I had to change. But there were some fun times.
    Good luck!
  7. by   kaycee
    We have had new grads come to our ER and with proper orientation and mentoring did very well. We've had some with Medsurg experience and with the same orientation that did not. Some nurses are made for ER and some are not.
    The only way you'll know is if you try.
    I never worked Medsurg out of school. I went right into critical care. SICU, CCU and then the last 20yrs ER. If you really want a specific area I say go for it!
  8. by   mattsmom81
    Not all hospitals are set up to take new grads into an area like ER or ICU. Internship programs, if you can find one, are great as they give you classroom introduction to the setting and a controlled learning experience. I have seen new grads do very well in a well planned internship program to critical care/ER...Go for it! And good luck
  9. by   LilgirlRN
    If all you ever want to do is the ED, then go there right out of school. You will not be well equiped to work anywhere else however. ER is different from anywhere else, after the patient leaves me, I really don't know what they do to him/her. I have patients ask me things I don't know the answer to all the time...like this for example, had a lady ask me if she had a bladder tack would she have to have a suprapubic catheter? My first inclination was to say no, but since I didn't really know I couldn't tell her for sure. Fortunately one of the nurses I work with did about 15 years of med-surg and told her what she could expect if she had the procedure done (no we weren't sending her from the ED to have it done, can hardly see that as emergent unless your bladder has prolapsed completely.) You see a little bit of everything in the ER, so you have to be ready for anything. Being a new grad is stressful enough as it is, but some of them do beautifully and some don't. Most of the time we are so busy, I sure don't have time to hold anyone's hand and walk them through things, it's easier to just do it myself. If you choose to do ED, make sure they give you a long enough orientation that you feel comfortable taking patients by yourself. Let you be the one to decide when you are ready. Good luck, Wendy
  10. by   ceecel.dee
    I think generalizing in the beginning works the best. Start Med/Surg for at least a year, then you have a great internal data base for all kinds of critical thinking, as well as a good idea of how to correctly transfer a pt, position a pt, potty a pt, instruct a pt, take your time with a pt, etc, etc.....
  11. by   Zee_RN
    I have hired two new grads to work in our E.D. this year. This is the first time we have hired new grads in E.D. We have been selective though. The one new grad has been a paramedic for 9 years. The other has been working as a nurse's aide in an E.D. for 3 years and as such is knowledgeable of the flow, the roles and types of patients and expectations of an E.D.

    So I guess my answer is...it depends on the graduate and the experienced E.D. nurses' willingness/ability to mentor and the department management's willingness to allow them to do so.
  12. by   ERNurse752
    It's largely individual...
    I went into ER right after graduation and did fine with my duties...the issues of my ER are another story, however. hehe
    I had worked in CICU for 3 1/2 years in school, did a 12 week ICU internship in a Level 1 Trauma Center, and did a 16 week internship between ER and cardiovascular recovery room after I graduated...so my experiences definitely helped me a little bit. But ER is a totally different world from any other type of nursing...
    We've had some new grads with no hospital experience do better than some experienced nurses with several years of med-surg...and even ICU!
    It just depends.
    Whatever you do, make sure the staff is knowledgeable and supportive. Find out if the staff is reasonably happy overall...find out what the turnover is.
    Don't go into a bad situation fresh out of school (heck, or any other time!) or you'll crash and burn early on...
  13. by   ERNurse752
    Oh yeah...
    So go for it if that's what you want!
    Good luck!
  14. by   lawsrnmom
    I worked as a secretary and nurse aide during nursing school (2 yr degree) in the ER. It helped me tremendously with nursing school. After graduation I worked on the med/surg float pool for 4 months (only because at the time there were these things called "hiring freezes".....) then returned to the ER. I felt comfortable and was ready to dive in, learn, get all the certifications that I could and be a competant ER nurse. And I was.

    It all depends on you. If your orientation is not making you feel comfortable as an ER nurse then talk to your preceptor and make changes. If you want it, you can do it.

    I would suggest critical care for experience before becoming a trauma nurse.

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